AL amyloidosis with temporal artery involvement simulates giant-cell arteritis

被引：18
|
作者：
Audemard, Alexandra [1 ]
Boutemy, Jonathan [1 ,4 ]
Galateau-Salle, Francoise [2 ,4 ]
Macro, Margaret [3 ]
Bienvenu, Boris [1 ,4 ]
机构：
[1] CHU Caen, Dept Internal Med, F-14000 Caen, France
[2] CHU Caen, Dept Pathol, F-14000 Caen, France
[3] CHU Caen, Dept Haematol, F-14000 Caen, France
[4] Univ Caen Basse Normandie, UFR Med, F-14000 Caen, France
来源：
JOINT BONE SPINE | 2012年 / 79卷 / 02期
关键词：
AL amyloidosis; Primary amyloidosis; Giant-cell arteritis; Temporal arterial biopsy; PRIMARY SYSTEMIC AMYLOIDOSIS; INTERNAL ELASTIC LAMINA; MONOCLONAL GAMMOPATHY; JAW CLAUDICATION; DEPOSITS; DISEASE;
D O I：
10.1016/j.jbspin.2011.09.007
中图分类号：
R5 [内科学];
学科分类号：
1002 ; 100201 ;
摘要：
Light-chain (AL) amyloidosis may present with features suggesting vasculitis, including giant-cell arteritis (GCA). We describe a case of an 80-year-old man, who initially presented with bilateral jaw claudication, bi-temporal headache and arthralgia, however a temporal-artery biopsy then revealed AL amyloidosis. A diagnosis of AL amyloidosis complicating multiple myelome simulates GCA and polymyalgia rheumatica was established. The patient was successfully treated with melphalan and dexamethasone: the free kappa light chains decreased, the patient's jaw claudication and headache disappeared. Then we discuss similarities between GCA and AL amyloidosis and potential confusion in diagnosis. We suggest that, in patients with clinical features of GCA without any temporal-artery typical findings, specimens are stained with Congo red, which then results in a different diagnosis and treatment. (C) 2011 Societe francaise de rhumatologie. Published by Elsevier Masson SAS. All rights reserved.
引用
收藏
页码：195 / 197
页数：3
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